To anyone else, it looks like an ordinary family shopping spree. But to Stensland, this retail splurge represents so much more.

At 19, after years of enduring migraines, backaches and unwelcome stares, the Fargo woman had breast reduction surgery.

Six pounds of breast tissue were removed from her small-boned, 5-foot 3-inch frame. She went from a 36DDD bra size to a more proportionate 36B. Now, for the first time in years, Stensland can wear the same youthful clothes her girlfriends have always worn.

And there's the irony: By becoming less curvaceous, Stensland now has the confidence to dress more feminine.

She isn't alone. Breast reduction surgeries have increased 25 percent from 2000 to 2007, according to the American Society of Plastic Surgeons. But even so, Stensland is a bit of an anomaly. The society's statistics show most women get the procedure between the ages of 40 and 54, with the fewest receiving it during teen years.

"I thought it would be good to do this now, so I can live my life while I'm young," Stensland says, her bright blue eyes sparkling. "It's totally worth it. I would do it again in a heartbeat."

Self-conscious teen

The closet of Stensland's bedroom could belong to a teenage boy. It's filled with jeans and hoodies - Stensland's standard outfit before surgery.

The hoodie collection started in junior high, as Stensland hid her rapidly developing curves under bulky clothes, a habit she's kept until recently.

While her friends shopped for trendy outfits in the juniors section, Stensland always wound up in the plus-size department because of her chest size. She never wore dresses; they required too much altering to fit properly.

"I've always looked at other girls and thought: 'What's wrong with me? Why am I bigger than them?' " she says.

The reactions from others didn't help. People would meet her and announce that she had an enormous chest. "I never knew if a guy was interested in me or my body," she says.

Despite her self-consciousness about her figure, Stensland still viewed herself as "pretty outgoing."

But the worst part for her was the physical toll. The weight of her breasts pulled her spine out of alignment, triggering migraines, backaches and neck problems. Her bra straps left grooves in her shoulders, and she had trouble standing up straight. She even struggled to find a comfortable sleeping position at night.

Stensland's career choice as a Le Cordon Bleu-trained chef didn't make life easier. Cooking requires hours of standing, bending over countertops and lifting heavy pots and pans.

While completing a culinary externship in Seattle, Stensland worked on an organic farm. That meant bending at the waist to pick produce. "I was screaming in my head," she recalls. "I couldn't take the pain."

A long road

After years of watching their only child struggle with her body, Ruth and David Stensland made an offer: They would pay for her surgery.

At their family doctor's recommendation, they consulted with Dr. Ahmed Abdullah at the Plastic Surgery Institute of Fargo. Abdullah, who performs an average of three breast reductions a week, was straightforward about the procedure. He told her it was major surgery, with all the same risks. She would have permanent scars. And she probably wouldn't be able to breastfeed afterward.

He also asked questions to ensure Stensland was in the right state of mind. Why did she want this? Was she doing it for appearance reasons alone? Did she want this for herself or for someone else, like a boyfriend?

Stensland assured him she was doing it for herself and to live pain-free. And she wasn't concerned about the nursing issue - she had been adopted and raised on bottles, and she plans to adopt her children as well.

She opted for the surgery. The procedure was originally scheduled for Dec. 6, but became mired in red tape. The family's insurance carrier, Blue Cross Blue Shield of Illinois, typically views breast reduction as cosmetic, and requires its subscribers to exhaust all other options before it will approve surgery.

Stensland spent the next few months trying everything from physical therapy to hot/cold packs to anti-inflammatory drugs to alleviate her neck and back pain. The measures helped temporarily, but didn't last long.

Finally, the company approved Stensland's operation and agreed to pay for 80 percent of the $10,000 procedure.

A new surgery date was set for Monday, Feb. 22.

Surgery day

The morning of the operation, Stensland showed few signs of nervousness. Ruth was worrying enough for both of them.

Teary-eyed, Ruth confessed she was up half the night, fretting about her daughter. She also was anxious about being Sarah's caretaker for the next three or four weeks of recovery.

During the two- to three-hour surgery, Abdullah removed excess fat and glandular tissue from the lower and outer portions of the breasts, then reshaped them. The nipples and areola were removed and transplanted to a higher position on the breast. The incisions were closed, creating an anchor-shaped scar on the lower half of each breast.

By early afternoon, Stensland was awake in the recovery room. She wore snug bandages covered by a surgical bra outfitted with drainage tubes. She would be home and sleeping in her own bed that night.

Three weeks later, Stensland is standing in her bathroom, brushing sparkly violet shadow on her eyelids and sweeping brown-black mascara on her lashes.

Her friends are holding a party to celebrate her new figure, and she couldn't wait to show them the new Sarah.

The previous weeks of recovery hadn't been easy. Stensland's prescribed painkillers made her sick. She couldn't work or lift anything for several weeks. But now she feels like a new woman.

She slides into her new dress - the one with the purple stripes - and some daringly high wedge sandals.

As she walks slightly wobbily into the room, her parents and aunt ooh and aah.

Sarah, cutting a trim profile in her new ensemble, glows with confidence. This night, she says, feels better than her high school prom did. "Back then, it was like: 'Can I wear a sweatshirt over my dress?' "

After years of hiding her voluptuous shape, Stensland finally feels comfortable dressing feminine.

She also feels stronger and healthier. She's found her job as a line cook at Sarello's restaurant is so much easier these days. "I'll think, 'Ohmigosh, I'm not hurting at the end of the night.' "

With hoodies, headaches and self-consciousness behind her, Stensland is anxious to start life anew.

"Now I can't wait till summer," she says.

About breast reduction

* Breast reduction is one of the top five reconstructive procedures performed by plastic surgeons.

* In 2007, 106,179 breast reductions were performed. Of those, most (37,654) were done on women ages 40 to 54. The least (6,329) were done on teens ages 13 to 19.